Necesidad de cuidados paliativos en pacientes VIH/sida en un hospital de tercer nivel en La Habana. Utilidad del cuestionario NECPAL

Abstract

Introduction: Attention to HIV/AIDS infection in Cuba as a chronic disease demands integrative solutions, for which the perspective of palliative care could be an important contribution. Objective: To explore the need for palliative care in hospitalized HIV/AIDS patients by health providers. Method: An observational, cross-sectional study was carried out at the “Pedro Kourí” Institute of Tropical Medicine between March and April 2016, with patients infected by the human immunodeficiency virus in the AIDS stage. The exclusion criteria were the willingness of the patient not to be part of the study and those cases that died 48 hours after admission. The NECPAL questionnaire was applied to the attending physicians to identify patients with palliative care needs. Results: Of the 123 patients studied, 87.8 % were men, under 45 years of age (66.7 %), with more than 10 years of HIV diagnosis (33.3 %). 65.0 % had CD4 + < 200 cells/ml and 87.0 % had detectable CV. The NECPAL instrument yielded 75 patients (61.0 %) with positive identification. The wasting syndrome (p > 0.006, OR 3.9 [95% CI 1.4-10.4]) and the presence of anemia (p > 0.001, OR 4.7 [95 % CI 1.9 -11.8]) were the variables that were related to the positive identification of NECPAL. Conclusions: The NECPAL instrument was useful in detecting palliative needs by medical assistance personnel who care for HIV/AIDS patients, and who do not have training in palliative care.